Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 00587 | Date 20/08/2018 |
| Token No | SM/18-19/2017 24/09/2018 | Serial | 076 Last Visit: 24/09/2018 |
| Patient Name | Mrs. ASMA KHATUN | Contact No | 7890841248 |
| Address | 1,CHATRA MUSALMANPARA/LANE | Age | 11.0 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 25 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||